Hepatitis C Virus Infection Is Positively Associated with Gallstones in Liver Cirrhosis

Abstract

Aim: To elucidate the prevalence and risk factors of gallstone disease (GD) among patients with liver disease and explore their association with the aetiology and severity of hepatic injury. Methods: We analysed 4,832 subjects of hepatic injury induced by one of the following aetiologies: hepatitis B virus (HBV) infection, hepatitis C virus (HCV) infection, excessive alcohol consumption. The risk factors significantly associated with GD were analysed using stepwise logistic regression analysis, the influence of aetiology and severity of liver disease on the prevalence of GD were assessed by multiple logistic regression analysis adjusting for confounding factors. Results: Three thousand forty eight patients were of positive HBV surface antigen alone with a prevalence of GD of 18.6%, 526 were tested as positive Anti-HCV alone with a prevalence of GD of 22.4%, and 1,258 were identified with excessive alcohol consumption patterns with a prevalence of GD of 13.5%. In each aetiological category, the prevalence of GD increased by age. Stepwise logistic regression analysis showed that age, female, low-density lipoprotein-cholesterol (LDL-Cho), family history of GD, HBV infection, HCV infection, chronic hepatitis and cirrhosis were independent associated with HCV-related cirrhosis in both genders, HBV-related cirrhosis in males and alcohol-related cirrhosis in females compared with patients with less severe liver disease. After adjusting for gender, age, LDL-Cho and family history of GD, patients with HCV-related cirrhosis (OR 2.66, 95% CI 1.49-3.84) but not HBV-related cirrhosis (OR 1.52, 95% CI 0.73-1.82) were more likely to have GD compared with alcohol-related cirrhosis. Conclusion: HCV infection is positively associated with gallstone formation especially in those with cirrhosis patients.

Hepatitis E Virus Infection Caused Elevation of Alanine Aminotransferase Levels in a Patient with Chronic Hepatitis B and Choledocholithiasis

“…It is unknown whether HBV infection is associated with choledocholithiasis [76]. A significantly increased risk of developing gallstones among HCV-infected patients was reported [77][78][79][80][81][82][83]. HEV genotype 3 infection was also found to be associated with gallstone-related diseases, including biliary pancreatitis [84].…”

Hepatitis C Virus Infection Increases Risk of Gallstone Disease in Elderly Chinese Patients with Chronic Liver Disease

“…Moreover, we did not find a positive correlation between TBIL levels and gallstone formation. Correlations between TBIL levels and GD remain controversial and needed to be further discussed combined with gallstone type 7 , 39 .…”

“…Determining the potential relationship between the development of gallstones and the etiology of CLD is of great interest, as previous research has suggested that HCV infection is a relevant risk factor for gallstone formation 6 . Recent studies have found that gallstones may occur more frequently in patients infected with HCV than in either patients infected with HBV or alcoholics 7 – 10 . In Italy, a multicenter survey demonstrated that GD prevalence among patients with liver cirrhosis was associated with HCV infection but not with excessive alcohol consumption 11 .…”

Effects of gender and age on prevalence of cholelithiasis in patients with chronic HCV infection

“…[14,15] In patients with chronic liver disease, the presence of gallstones is associated with the degree of liver dysfunction, with gallstone formation occurring more readily in liver cirrhosis compared to normal biochemistry or chronic hepatitis without cirrhosis. [16] Gallstones are found in chronically infected HCV patients at a younger age than in those without liver disease and are associated with central obesity and liver steatosis, but not inherited gallstone disease. [17] Although the complex relationship between HCV infection and gallstone disease is not explained precisely, biliary lithogenesis is suggested as a related factor to HCV infection.…”

“…[19,20] The male-dominant prevalence of cholelithiasis in chronic HCV-infected individuals may be attributable to age over 50 years and more progressive underlying liver pathology in males compared to females; anti-HCV was only associated with males, and not with females. [16] Nevertheless, women of all ages are still twice as likely as men to develop cholesterol gallstones from puberty through childbearing years before tapering off, highlighting the possible influence of female sex hormones. [21,22]…”